Inhibitory effect of N-acetyl cysteine and ascorbic acid on the development of myringosclerosis: an experimental study

Effects of Papaverine on Experimentally Induced Myringosclerosis

OBJECTIVE

This study aims to investigate the effects of papaverine on experimentally induced myringosclerosis (MS). MS is characterized by hyaline degeneration and calcification of the lamina propria of the tympanic membrane and can adversely affect hearing function if left untreated. The study examined the potential effects of both systemic and topical applications of papaverine on this process.

MATERIALS AND METHODS

In the study, 20 Wistar albino rats were used. The rats were divided into 4 groups and different treatment methods were applied in each group. In group 1, myringotomy was performed, but no additional intervention was performed. In group 2, saline-impregnated gelfoam was applied after myringotomy. In groups 3 and 4, topical and systemic applications of papaverine hydrochloride were performed. Tympanic membranes were examined under a microscope after 21 days, and the severity of MS and histopathologic changes were evaluated.

RESULTS

The papaverine-treated groups observed a significant increase in otomicroscopic sclerosis, the degree of inflammation, and tympanic membrane thickness. The degree of fibrosis was higher in group 3 compared with the other groups. The results showed that papaverine administration increased the occurrence of MS.

CONCLUSION

This study suggests that papaverine may increase MS through its vasodilating effect. Vasodilation is thought to cause an increase in oxygen-derived free radicals, which may contribute to the pathogenesis of MS. The results suggest that the effects of papaverine on MS should be carefully evaluated.

Retinoic acid induces antimicrobial peptides and cytokines leading to Mycobacterium tuberculosis elimination in airway epithelial cells

Tuberculosis (TB) is the leading cause of death by a single infectious agent, Mycobacterium tuberculosis (Mtb). Alveolar macrophages and respiratory epithelial cells are the first cells exposed to Mtb during the primary infection, once these cells are activated, secrete cytokines and antimicrobial peptides that are associated with the Mtb contention and elimination. Vitamins are micronutrients that function as boosters on the innate immune system, however, is unclear whether they have any protective activity during Mtb infection. Thus, we investigated the role of vitamin A (retinoic acid), vitamin C (ascorbic acid), vitamin D (calcitriol), and vitamin E (alfa-tocopherol) as inductors of molecules related to mycobacterial infection in macrophages and epithelial cells. Our results showed that retinoic acid promotes the expression of pro- and anti-inflammatory molecules such as Thymic stromal lymphopoietin (TSLP), β-defensin-2, IL-1β, CCL20, β-defensin-3, Cathelicidin LL-37, TGF-β, and RNase 7, whereas calcitriol, ascorbic acid, and α-tocopherol lead to an anti-inflammatory response. Treatment of Mtb-infected epithelial cells and macrophage-like cells with the vitamins showed a differential response, where calcitriol reduced Mtb in macrophages, while retinoic acid reduced infection in epithelial cells. Thereby, we propose that a combination of calcitriol and retinoic acid supplementation can drive the immune response, and promotes the Mtb elimination by increasing the expression of antimicrobial peptides and cytokines, while simultaneously modulating inflammation.

The Effect of Curcumin on the Prevention of Myringosclerosis in Rats

OBJECTIVE

The aim of this study was to investigate the preventative effect of oral curcumin (CMN) on myringosclerosis (MS) in an experimental rat model.

METHODS

The study included 21 female Wistar albino rats randomly separated into three groups. Group 1 was given no treatment (control group). In Group 2 and Group 3, the tympanic membrane (TM) was perforated using a sterile ear pick. The rats in Group 3 were administered oral CMN 200 mg/kg/day. All rats were sacrificed after 16 days. Otomicroscopic and histopathologic examinations were performed on the tympanic membranes.

RESULTS

Histopathologic examinations revealed that there were statistically significant differences between Group 2 and Group 3 in terms of MS degrees (p<0.001) and mean thicknesses of TMs (p<0.001), but there were no differences between Group 1 and Group 3. In respect of MS detected by otomicroscopy, a statistically significant difference was determined between Groups 1 and 2 (p<0.001) and between Groups 2 and 3 (p<0.01), but there was no significant difference between Group 1 and Group 3 (p=0.575).

CONCLUSION

Orally administered CMN can prevent myringosclerosis formation in experimentally induced myringotomies.

Management of otitis media with effusion in children. Société française d'ORL et de chirurgie cervico-faciale clinical practice guidelines

The Société française d'ORL et de chirurgie cervico-faciale clinical practice guidelines concern the management of otitis media with effusion (OME) in children under the age of 12 years. They are based on extensive review of MEDLINE and Cochrane Library publications in English or French from 1996 to 2016 concerning the methods of diagnosis and assessment of otitis media with effusion, as well as the efficacy of tympanostomy tubes and medical and surgical treatments of OME.

Ascorbic Acid Attenuates Multifidus Muscles Injury and Atrophy After Posterior Lumbar Spine Surgery by Suppressing Inflammation and Oxidative Stress in a Rat Model

STUDY DESIGN

A rat model of multifidus muscles injury and atrophy after posterior lumbar spine surgery.

OBJECTIVE

We determined the effect of ascorbic acid (AA) on the postoperative multifidus muscles in rat model.

SUMMARY OF BACKGROUND DATA

Previous studies show oxidative stress and inflammation are two main molecular mechanisms in multifidus muscle injury and atrophy after posterior lumbar surgery. AA may have a protective effect in postoperative multifidus muscles.

METHODS

Rats were divided into sham surgery, control surgery, and surgery plus AA groups. Multifidus muscles of the control and AA groups were excised from the osseous structures. The muscles were retracted continuously for 2 hours. In the sham and AA groups, AA was administered via oral gavage daily in the first week. In each group, the oxidative stress was evaluated by measuring malondialdehyde (MDA) and Total superoxide dismutase (T-SOD). The inflammation, fat degeneration, or fibrosis of multifidus muscle were evaluated by quantitative real-time polymerase chain reaction (q-PCR), histology, or immunohistochemical analysis.

RESULTS

T-SOD activity was significantly lower in the control group than that in the AA group in the first week. MDA levels were significantly higher in the AA group. Interleukin-6 and tumor necrosis factor-α in multifidus muscles also showed significant differences when treated with AA. The inflammation score on histology was significantly lower in the AA group postoperatively in the first week. In the long run, marker genes for fibrosis and fat degeneration, and fibrosis and fat degeneration scores, were significantly lower in the AA than the control group on days 14 and 28 postoperatively.

CONCLUSION

In conclusion, AA attenuated the oxidative stress and inflammation response in the postoperative multifidus muscles, and remarkable differences were observed from the histological assessment and related marker genes expression. Our results provided important insight into the anti-inflammatory and anti-oxidative effects of AA in the postoperative multifidus muscles.

LEVEL OF EVIDENCE

N/A.

Prolonged Mouse Cardiac Graft Cold Storage via Attenuating Ischemia-Reperfusion Injury Using a New Antioxidant-Based Preservation Solution

BACKGROUND

One of the major events in ischemia-reperfusion (I/R)-induced heart injury in cardiac transplantation is the generation of reactive oxygen species. We hypothesized that a novel preservation solution called SBI-SEIIKU II (SS-II) contains 3 antioxidant reagents: L-cysteine, glycine, ascorbic acid/ascorbic acid-2-phosphate magnesium, which can block the generation of reactive oxygen species to result in a prolongation of the cold storage time via attenuating I/R injury.

METHODS

C57BL/6CrSlc(B6) mice underwent syngeneic mice heterotopic heart transplantation, and the animals were derived into 3 groups: recipients with nonpreserved grafts (control group), recipients with grafts preserved in histidine-tryptophan-ketoglutarate (HTK) for 24 and 48 hours (HTK group), and recipients with grafts preserved in SS-II for 24 and 48 hours (SS-II group).

RESULTS

After 48 hours of preservation, there were no grafts that survived in the HTK group; however, the SS-II group had a high survival rate. After 24 hours of preservation, SS-II decreased the oxidative damage, myocardial apoptosis, and the infiltration of macrophages and neutrophils in the cardiac grafts in the early phase and suppressed the development of myocardial fibrosis in long-term grafts compared with HTK.

CONCLUSIONS

The SS-II prolongs the acceptable cold storage time and protects the myocardium from I/R injury via inhibiting oxidative stress-associated damage. We believe that this novel preservation solution may be simple and safe for use in the clinical transplantation field.

The effect of caffeic acid phenethyl ester (CAPE) on tympanosclerosis

OBJECTIVE

To investigate the effects of caffeic acid phenethyl ester (CAPE) on tympanosclerosis.

MATERIALS AND METHODS

Thirty-two male Sprague Dawley rats were separated into 4 groups as CAPE (n = 10), alcohol (n = 10), control (n = 8) and normal (n = 4) groups. All tympanic membranes except normal group were myringotomised and type 3 Streptococcus pneumoniae strains was injected into their middle ears. Myringotomies were repeated for 5 weeks. Intraperitoneal (i.p) CAPE were administrated to the CAPE group at 10 μmol/kg/day and 10% ethyl alcohol administrated to the alcohol group for 5 weeks. The control group were left untreated. Findings of myringosclerosis were recorded by otomicroscope at sixth week. Then, all rats were sacrificed and tympanic membrane thickness and severity of middle ear mucosal inflammation evaluated histopathalogically.

RESULTS

Severity of myringosclerosis was significantly higher in the alcohol and control groups compared to the CAPE group (p < 0.001), but was not significant when alcohol and control groups were compared (p = 0.17). The tympanic membrane thickness measured in the alcohol and control groups were significantly higher compared to the CAPE group (p < 0.001), but was not significant when alcohol and control groups were compared (p = 0.17). The severity of inflammation in the middle ear mucosa was significantly higher in the alcohol and control groups compared to the CAPE group (respectively, p < 0.001, p = 0.03). The severity of inflammation in the middle ear mucosa was not significant between alcohol and control groups (p = 0.30).

CONCLUSION

CAPE has anti-inflammatory and antioxidant effects on the development of MS in myringotomized rats, so reduces the severity of tympanosclerosis.

The effect of melatonin and vitamin C treatment on the experimentally induced tympanosclerosis: study in rats

Introduction

The ethiopathogenesis of tympanosclerosis has not been completely under- stood yet. Recent studies have shown that free oxygen radicals are important in the formation of tympanosclerosis. Melatonin and Vitamin C are known to be a powerful antioxidant, interacts directly with Reactive Oxygen Species and controls free radical-mediated tissue damage.

Objective

To demonstrate the possible preventative effects of melatonin and Vitamin C on tympanosclerosis in rats by using histopathology and determination of total antioxidant status total antioxidant status.

Methods

Standard myringotomy and standard injury were performed in the middle ear of 24 rats. The animals were divided into three groups: Group 1 received melatonin, Group 2 received vitamin C, and Group 3 received saline solution.

Results

The mean values of total antioxidant status were similar in the all study groups before the treatment period. The mean values of total antioxidant status were significantly higher in the melatonin and vitamin C groups compared to control group but vitamin C with melatonin groups were similar after the treatment period (p < 0.001). Minimum and maximum wall thicknesses were lower in the melatonin and vitamin C groups compared to the control group but the differences were insignificant.

Conclusion

Melatonin increases total antioxidant status level and might have some effect on tympanosclerosis that develops after myringotomy.

An Analysis of Surgical Treatment Results of Patients With Tympanosclerosis

OBJECTIVE

The authors aimed to evaluate the intraoperative features and the results of postoperative hearing gain successes of patients with tympanosclerosis who were treated surgically in our clinic.

MATERIAL AND METHODS

A retrospective analysis was conducted on 151 ears with tympanosclerosis of 138 patients who operated because of chronic otitis media or only tympanosclerosis, between January 2007 and June 2014. They were evaluated by appealing complain, complain duration, accompanying systemic disorders, tympanic membrane condition, localization of sclerotic plaque, damage in ossicular chain, existence of cholesteatoma, operation procedure type, hearing reconstruction type, preoperative, and last postoperative audiometric findings in every frequency both bone and air way.

RESULTS

In the group of Wielinga-Kerr Group 3 (isolated stapes fixation), no statistically significant results were found in preoperative and last postoperative audiometric findings in every frequency both bone and air conduction (BC and AC) (P > 0.05). In the Wielinga-Kerr Group some results had significant (P < 0.05) and some results had highly significant (P < 0.001).

CONCLUSIONS

Patients with less impact on ossicular chain and limited localization of sclerotic plaques have better hearing gain. Although surgery is still controversial in tympanosclerosis; it is the most effective treatment till new effective medication is discovered.

Enhanced expression of hepatocyte growth factor in the healing of experimental acute tympanic membrane perforation

OBJECTIVES

The present study was performed to investigate the expression of hepatocyte (HGF), epidermal (EGF) and vascular endothelial (VEGF) growth factors in the course of healing of experimental tympanic membrane (TM) perforations in rats. The goal was to explain the role of these growth factors in the healing process of TM and to assess the possibility of their future application as healing promoters.

METHODS

Seventy rats were used, of which 10 served as controls and the others had their TM perforated. The experimental animals were divided into six subgroups on the basis of time points (01, 03, 05, 07, 09, 15 day after injury). Videootoscopy and histology were employed to assess the morphology of the healing process. The expressions of HGF, EGF and VEGF were evaluated using Western blot analysis. Tissue localization of HGF was determined by the immunofluorescence method.

RESULTS

HGF was hardly detectable in normal TM; however, a significant increase was noted in its expression starting from the third day after injury throughout the follow-up period, with the highest level on day 05. The analysis of HGF tissue localization with immunofluorescence revealed diffuse staining in the cytoplasm of proliferating epithelial cells. The expression of EGF was elevated on the first day after injury, not reaching statistical significance, and then returned to the level observed in the control TM. No significant differences were noted in the expression of VEGF.

CONCLUSION

High expression of HGF during the healing process of acute TM perforations makes it a promising candidate for further studies oriented towards its possible use in augmentation of TM healing.